An update on David's right eye

In the last few weeks since we arrived back in the UK from France, David has been complaining of reduced sight in his right (good) eye. He has complained about his sight having what looked like a net curtain across whatever he saw. It has affected him quite severely in that he is no longer confident crossing unknown roads on his own, and has determined he can no longer do supermarket shopping by himself, esp in supermarkets he is not familiar with, i.e. every supermarket we come across on the boat!

The onset of this prompted him to get in touch with the ophthalmologist in Birmingham that Keith Small (the Wellington ophthalmologist who has been his specialist for some time, as well as being the one who removed the cataract in the right eye and treated the left eye for the acute malignant glaucoma on the same day).

Today we saw Professor Peter Shah at the BMI Priory Hospital in Edgbaston, Birmingham.

The news was both bad and good.

The bad news is his diagnosis: since the cataract operation, David’s eye has developed a rare condition called Anterior Capsular Phimosis:

• the capsule that the new lens sits in has developed fibrosis plus a lot of scar tissue, and
• the opening, which is meant to be about 5mm in diameter, is closing over and is now down to 0.75mm. This explains why David is looking through a fog all the time.
• If left untreated, his sight is at risk.

The good news is that Peter Shah:

• is a world-renowned ophthalmologist and mostly treats people with only one functioning eye
• has seen and treated this condition before
• said there is a 99.5% chance that all will be well, after assessment and treatment, and
• said that it is entirely possible he will see better than he ever has before.

The other good news is that, for the second time in a row, David has been in the right place with the right people when bad stuff has happened with his eyes - first one was when we were at the Southern Cross Hospital and Keith Small saw his left eye with the Acute Malignant Glaucoma and was able to start treatment right away; and today, here we were with a world-renowned expert when this ACP shows up.

So instead of today being a one off appointment, David is now in line for:

• an appointment with Peter Shah early on Friday morning, and again on Saturday morning (arranged) in Birmingham
• an appointment for a series of ultrasounds late on Friday morning (arranged) in Birmingham
• an appointment for a retinal scan (TBA)
• an appointment for a visual field test (TBA)
• a follow-up appointment with Peter Shah for discussion of the test results and treatment options (TBA for late next week).

At this point, we are unsure whether we should return to NZ for the treatment or have it done here by Peter Shah. He was at pains to point out that treatment in NZ may be more advisable because:

• one operation may not sort the problem and multiple surgeries may be required, and as they will have to be done privately here in the UK, they will cost - we don’t yet have any idea how much that is likely to be.
• there is a chance that catastrophe could occur (i.e. the eye fails and David goes blind in that eye) - being in NZ would mean we are closer to support systems. However, as we have a floating home here and at least one of our children plus grandkids, here is as good as NZ in that respect.

We discussed it on the way back to the boat and there are pros and cons for either option:

• Peter is one of the most experienced ophthalmic surgeons in the world and has a vast body of experience with a far larger number of patients than has been available to Keith in NZ
• being home in NZ, if the treatment is longer term, would simplify the pension situation (of not being able to be out of the country more than 6 months - although we have no doubt that MSD would not enforce that rule in the case of medical requirements)
• if it had to be done privately in NZ, the cost would be lower than in the UK
• it probably wouldn’t have to be done privately because Keith would assess it as acute, so it would be done urgently in the public system for free.

I think that covers it - you are now as up to date with info as we are.

It has been an emotionally draining day, and the gin and chardonnay are coming out, now we are back on the boat overnight. We head back to Birmingham tomorrow (Thursday) to be close by for the Friday and Saturday appointments. Depending on if we decide on treatment here in the UK, we would move the boat up to Birmingham and live in a marina there to make treatment easier to access.

In the meantime, we have moved the boat into a marina at Gayton which is between Northampton and Milton Keynes, and we can come and go from here by rental car quite easily.

Mxx